Improving lexical retrieval with LingoTalk: an app-based, self-administered treatment for clients with aphasia

Probably not a substantial claim: may not pass S3 (load-bearing).

P2's word length and articulatory complexity did not influence naming performance.

“Word length and articulatory complexity did not influence naming performance.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

P1's spontaneous speech was non-fluent and agrammatic, with frequent word-finding difficulties and mild apraxia of speech.

“Her spontaneous speech was non-fluent and agrammatic, characterized by frequent wordfinding difficulties, and displayed mild symptoms of apraxia of speech.”

May combine two claims.

Google Speech rejected 24 responses that the SLTs rated as correct and accepted one response that the SLTs rated as incorrect.

“Google Speech rejected 24 responses that the SLTs rated as correct and accepted one response that the SLTs rated as incorrect.”

May combine two claims.

P1's oral naming was impaired (50% correct in WPP) with no effects of word frequency, word length, or articulatory complexity.

“Neurolinguistic assessment revealed impaired oral naming [50% correct in WPP (Blanken et al., 1999)] with no effects of word frequency, word length, or articulatory complexity.”

• cites Blanken et al., 1999Not checked yet

  Not checked in the free run.

May combine two claims.

All participants successfully completed the intervention with LingoTalk, although one participant was not able to use the ASR feature.

“All participants successfully completed the intervention with LingoTalk, although one participant was not able to use the ASR feature.”

May combine two claims.

P1 had global aphasia confirmed by the AAT, although clinical observation was more indicative of Broca's aphasia.

“Assessment with the AAT (Huber et al., 1983) confirmed a global aphasia, although clinical observation was more indicative of Broca's aphasia.”

• cites Huber et al., 1983Not checked yet

  Not checked in the free run.

May combine two claims.

P2's oral naming was impaired (65% correct in WPP), and performance for high-frequency words was significantly better than for low-frequency words (24/30 vs. 15/30, p = 0.029; Fisher's exact test).

“Oral naming was impaired [65% correct in WPP (Blanken et al., 1999)], and performance for highfrequency words was significantly better than for low-frequency words (24/30 vs. 15/30, p = 0.029; Fisher's exact test).”

• cites Blanken et al., 1999Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

P2's spontaneous speech was non-fluent, characterized by incomplete sentences due to word-finding difficulties.

“Her spontaneous speech was non-fluent, characterized by incomplete sentences due to word-finding difficulties.”

May combine two claims.

P2's errors were mostly semantically related to the target, with few phonological paraphasias.

“There were few phonological paraphasias, but most errors were semantically related to the target.”

May combine two claims.

P1's basic semantic knowledge was preserved, whereas oral reading of regular and irregular words was impaired (23% correct in LEMO 2.0/subtest T8).

“According to BOSU (Glindemann, 2002), basic semantic knowledge was preserved, whereas oral reading of regular and irregular words was impaired [23% correct in LEMO 2.0/subtest T8 (Stadie et al., 2013)].”

• cites Glindemann, 2002Not checked yet

  Not checked in the free run.

• cites Stadie et al., 2013Not checked yet

  Not checked in the free run.

May combine two claims.

All participants became considerably faster throughout the therapy process; sessions initially lasted ~40-45 minutes, but by the end were completed in 5-10 minutes.

“All participants became considerably faster throughout the therapy process.Initially, sessions lasted ∼40-45 minutes, but by the end of the treatment period, they were completed in just 5-10 min.”

Probably not a substantial claim: may not pass S3 (load-bearing).

P3 enjoyed training on his own as he was

“P3, on the other hand, enjoyed training on his own as he was”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

P1 liked working with LingoTalk but found practicing on her own somewhat monotonous.

“P1 liked working with LingoTalk but found practicing on her own somewhat monotonous.”

May combine two claims.

Participants completed 12 to 17 training days instead of six face-to-face sessions within 3 weeks.

“Instead of six faceto-face sessions within 3 weeks, the participants completed 12 to 17 training days, which aligns much closer with the recommended minimum daily speech therapy dosage (Deutsche Gesellschaft für Neurologie, 2011).”

May combine two claims.

P3's oral naming was impaired (70% correct in WPP) and affected by word frequency (high: 25/30 vs low: 17/30; p=0.047) and word length (1 syllable: 17/20 vs 3 syllables: 10/20, p=0.041).

“Oral naming was impaired [70% correct in WPP (Blanken et al., 1999] and affected by word frequency (high: 25/30 correct vs. low: 17/30; p = 0.047) and word length (1 syllable: 17/20 vs. 3 syllables: 10/20, p = 0.041).”

• cites Blanken et al., 1999Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

Spontaneous speech analysis was not very informative for P2 because her reactions in baseline A2 were rather taciturn and brusque.

“Spontaneous speech analysis was not very informative as P2's reactions in baseline A2 were rather taciturn and brusque as she knew that she had answered the very same questions already before.”

May combine two claims.

P1's training effect was sustainable; naming accuracy 8 months after treatment was still significantly better than before (12/50 vs. 39/50, p < 0.001).

“This training effect was sustainable and naming accuracy 8 months after treatment was still significantly better than before (12/50 vs. 39/50, p < 0.001).”

• AssumptionRests on an assumption: The automatic speech recognition (ASR) in LingoTalk correctly identifies responses for P1 and P2, so ASR-based scoring is valid.

May combine two claims.

P2 found practicing independently on a daily basis demanding, leading to a decrease in motivation and occasional complaints, but she did not withdraw.

“In the case of P2, practicing independently on a daily basis was demanding, leading to a decrease in motivation and occasional complaints.Nevertheless, she did not withdraw from the study.”

Probably not a substantial claim: may not pass S3 (load-bearing).

P3's spontaneous speech was fluent but marked by various symptoms of word-finding difficulties, including hesitations, rewording, empty phrases, and repetition.

“His spontaneous speech was fluent but marked by various symptoms of word-finding difficulties, including hesitations, rewording, empty phrases, and repetition of words and phrases.”

May combine two claims.

P3's improved oral picture naming generalized to naming by definition (1/18 vs. 12/18, p = 0.003), i.e. treated items improved sustainably in an untreated task.

“Improved oral picture naming generalized to naming by definition (1/18 vs. 12/18, p = 0.003), i.e. treated items improved sustainably in an untreated task.”

May combine two claims.

The data demonstrated that all participants were able to use LingoTalk on their own, as each of them completed at least 29 training sessions within 3 weeks.

“The data demonstrated that all participants were able to use LingoTalk on their own, as each of them completed at least 29 training sessions within 3 weeks.”

May combine two claims.

P1 still had very many word-finding difficulties in spontaneous speech although their amount decreased a little bit (from one in 1.54 phrases to one in 2.18 phrases and one in 5.3 phrases in the follow up).

“There are still very many word-finding difficulties in spontaneous speech although their amount decreased a little bit (from one in 1.54 phrases to one in 2.18 phrases and one in 5.3 phrases in the follow up).”

May combine two claims.

P2's performance in the ANELT and external CAL did not change.

“While both the performance in the ANELT (Blomert and Buslach, 1994) and the external assessment of P2's communicative abilities (CAL) (Pulvermüller and Berthier, 2008) did not change”

• cites Blomert and Buslach, 1994Not checked yet

  Not checked in the free run.

• cites Pulvermüller and Berthier, 2008Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

After the treatment study concluded, P3 acquired a tablet computer of his own and continued using LingoTalk and started to use the internet.

“After the treatment study concluded, he acquired a tablet computer of his own.He not only continued using LingoTalk but also started to use the internet, for example, for searching about his hobbies.”

May combine two claims.

P3's basic semantic knowledge was preserved, and oral reading was significantly better than naming of the same words (59/60 vs 42/60, p<0.001).

“Basic semantic knowledge was preserved [cf.BOSU (Glindemann, 2002)], and the WPP (Blanken et al., 1999) showed that oral reading was significantly better than naming of the very same words (59/60 vs. 42/60, p < 0.001).”

• cites Glindemann, 2002Not checked yet

  Not checked in the free run.

• cites Blanken et al., 1999Not checked yet

  Not checked in the free run.

May combine two claims.

If they could not name an item, they were able to make use of gradually increasing cues and decided themselves if they wanted to use phonological, semantic, and/or graphemic cueing.

“If they could not name an item, they were able to make use of gradually increasing cues and decided themselves if they wanted to use phonological, semantic, and/or graphemic cueing.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Participants realized that they became much faster in naming items over time, resulting in shorter training sessions.

“They realized that they became much faster in naming items over time, resulting in shorter training sessions.”

May combine two claims.

The treatment with LingoTalk demonstrated robust and long-lasting practice effects but there was limited generalization to spontaneous speech.

“The treatment with LingoTalk demonstrated robust and longlasting practice effects but there was limited generalization to spontaneous speech.”

May combine two claims.

The most significant increase in accuracy occurred during the first week, followed by continued improvement in the second week, and finally, a consolidation in the third week.

“The most significant increase in accuracy occurred during the first week, followed by continued improvement in the second week, and finally, a consolidation in the third week.”

May combine two claims.

The third patient relied on self-assessment and demonstrated a high level of reliability in evaluating his own responses.

“The third patient relied on self-assessment and demonstrated a high level of reliability in evaluating his own responses.”

May combine two claims.

In P2 and P3, accuracy rates exceeded 75% and remained stable after 15 sessions.

“In the cases of two participants, P2 and P3, their accuracy rates exceeded 75% and remained stable after already 15 sessions, which could indicate a ceiling effect.”

May combine two claims.

ASR was successfully utilized by two out of three participants and offered the advantage of an immediate and objective feedback.

“ASR was successfully utilized by two out of three participants and offered the advantage of an immediate and objective feedback.”

May combine two claims.

Although the number of practiced items varied significantly among participants, the initial training sessions took ∼45 min for all of them.

“Although the number of practiced items varied significantly among participants, the initial training sessions took ∼45 min for all of them.”

May combine two claims.

There appeared to be an initial effect of having a supervisor present: performance of all participants dropped in the first self-training session compared to baseline, but this effect did not persist over the long term.

“While there appeared to be an initial effect of having a supervisor present -the performance of all participants dropped in the first self-training session compared to their baseline performance -this effect did not persist over the long term.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The project was approved by the research coordinator of the P.A.N Center.

“The project was approved by the research coordinator of the P.A.N Center.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Word-finding disorders have a significant impact on quality of life.

“have a significant impact on the quality of life (Hilari et al., 2016)”

• cites Hilari et al., 2016Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

Effective cueing techniques include phonological, semantic, auditory, and visual hints.

“Effective cueing techniques include phonological, semantic, auditory, and visual hints (Sze et al., 2021).”

• cites Sze et al., 2021Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

ASR enhances clients' independence from their SLT and strengthens their sense of competence, responsibility, and self-efficacy in rehabilitating their language skills.

“This enhances clients' independence from their SLT and strengthens their sense of competence, responsibility, and selfefficacy in rehabilitating their language skills.”

May combine two claims.

Clients are encouraged to practice more frequently, thereby achieving the intended intensive treatment.

“Clients are encouraged to practice more frequently, thereby achieving the intended intensive treatment (Stark and Warburton, 2018;Leinweber, 2021).”

• cites Stark and Warburton, 2018 sourceNot checked yet

  Not checked in the free run.

• cites Leinweber, 2021Not checked yet

  Not checked in the free run.

Classified as probably not a substantial claim.

Word-finding disorders severely limit everyday communication.

“they severely limit everyday communication (Blom Johansson et al., 2012)”

• cites Blom Johansson et al., 2012Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Participants provided written consent to participate in the study and could withdraw at any time and without giving any reason.

“They provided written consent to participate in the study and they could withdraw from the study at any time and without giving any reason.”

Classified as probably not a substantial claim.

No additional speech-language treatment was administered during the intervention with LingoTalk.

“All participants had received speech-language therapy before their involvement in the study, but no additional speech-language treatment was administered during the intervention with LingoTalk.”

May combine two claims.

With both Google Speech and SIRI operating with an accuracy rate of over 95%, the feedback provided by the app is reliable.

“With both Google Speech and SIRI operating with an accuracy rate of over 95%, we consider the feedback provided by the app to be reliable.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

Transparent progress monitoring of the intervention appears to positively influence patients' motivation.

“Transparent progress monitoring of the intervention appears to positively influence patients' motivation.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The research was conducted in accordance with the relevant institutional guidelines, including the EU General Data Protection Regulation (GDPR) and the Brandenburg State Data Protection Law (BbgDSG) as well as the German Research Foundation's Guidelines for Safeguarding Good Research Practice.

“The research was conducted in accordance with the relevant institutional guidelines, including the EU General Data Protection Regulation (GDPR) and the Brandenburg State Data Protection Law (BbgDSG) as well as the German Research Foundation's Guidelines for Safeguarding Good Research Practice.”

Classified as probably not a substantial claim. May combine two claims.

Brüsch (2022) suggests using three item sets for each participant: treated items, untreated items from treated topic, untreated items from untreated topic, each set 20-30 items and preferably different part of speech.

“To investigate item-specific effects as well as generalization, Brüsch (2022) suggests to use three item sets for each participant: (1) treated items, (2) untreated items from treated topic, (3) untreated items from untreated topic.Each set should contain 20-30 items and preferably different part of speech.”

• cites Brüsch (2022)Not checked yet

  Not checked in the free run.

May combine two claims.

P2's basic semantic knowledge was preserved, and the semantic errors were attributed to insufficient activation of the lexical entry in the POL, resulting in retrieval of a semantically similar response.

“As basic semantic knowledge was preserved [cf.BOSU (Glindemann, 2002)], the latter errors were attributed to insufficient activation of the lexical entry in the POL, resulting in the retrieval of a semantically similar response.”

• cites Glindemann, 2002Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

This divergence might be attributed to motivational factors as indicated by participants' comments.

“This divergence might be attributed to motivational factors as indicated by participants' comments.”

May combine two claims.

P3's drop in naming accuracy in sessions 28-37 was due to his attempt to use ASR again, which failed without him noticing, so none of his responses were identified as correct.

“Upon investigation, P3 explained that he had attempted to use the ASR once more.It seems that he failed to do so without noticing.Consequently, none of his responses were identified as correct during this period.”

May combine two claims.

The intervention with a digital application eventually sparked interest and instilled self-confidence for participating in digital services such as the use of search engines and websites.

“The intervention with a digital application eventually sparked interest and instilled self-confidence for participating in digital services such as the use of search engines and websites.”

Probably not a substantial claim: may not pass S3 (load-bearing).

P1 completed 30 sessions within 17 days.

“While P1 deviated only marginally by completing 30 sessions within 17 days”

Probably not a substantial claim: may not pass S3 (load-bearing).

Floor or ceiling effects were avoided by adjusting the level of difficulty based on LingoTalk's item difficulty rating.

“Floor or ceiling effects were avoided by adjusting the level of difficulty based on LingoTalk's item difficulty rating.”

May combine two claims.

As the performance in an unrelated control task remained stable, the item-specific training effect and the generalization to untreated items and the WPP can be attributed to the intervention with LingoTalk and are not caused by some general or unspecific improvement.

“As the performance in an unrelated control task [LEMO 2.0 T9, writing non-words by dictation (Stadie et al., 2013)] remained stable, the item-specific training effect and the generalization to untreated items and the WPP (Blanken et al., 1999) can be attributed to the intervention with LingoTalk and are not caused by some general or unspecific improvement.”

• cites Stadie et al., 2013Not checked yet

  Not checked in the free run.

• cites Blanken et al., 1999Not checked yet

  Not checked in the free run.

• AssumptionRests on an assumption: The control tasks used (writing non-words to dictation for P1, written picture naming for P2, oral non-word repetition for P3) are unrelated to oral naming and not practiced during intervention, so they can control for unspecific general improvement.

May combine two claims.

Although PlanBe was originally developed for individuals who use AAC, it proved to be suitable and beneficial for clients with aphasia as well.

“Although PlanBe (Pfeiffer and Leisner, 2016) was originally developed for individuals who use AAC, it proved to be suitable and beneficial for clients with aphasia as well.”

• cites Pfeiffer and Leisner, 2016Not checked yet

  Not checked in the free run.

May combine two claims.

Performance in an unrelated control task (WPP written naming) did not change for P2, tracing back the item-specific training effect to the intervention.

“Performance in an unrelated control task [WPP written naming (Blanken et al., 1999)] did not change, tracing back the item-specific training effect to our intervention.”

• cites Blanken et al., 1999Not checked yet

  Not checked in the free run.

• AssumptionRests on an assumption: The control tasks used (writing non-words to dictation for P1, written picture naming for P2, oral non-word repetition for P3) are unrelated to oral naming and not practiced during intervention, so they can control for unspecific general improvement.

Probably not a substantial claim: may not pass S3 (load-bearing).

P3 completed 46 training sessions within 16 days.

“P3 enjoyed working with the tablet computer and completed 46 training sessions within 16 days.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Involving patients in the item selection process and developing individual item sets makes the materials relevant to everyday life and usually increases motivation for the intervention.

“Involving patients in the item selection process and developing individual item sets makes the materials relevant to everyday life and usually increases motivation for the intervention (Renvall et al., 2013b).”

• cites Renvall et al., 2013bNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

LingoTalk's extensive database allowed for item selection tailored to the patients' individual needs.

“LingoTalk's extensive database allowed for item selection tailored to the patients' individual needs.”

Probably not a substantial claim: may not pass S3 (load-bearing).

P2 completed 29 sessions within 12 days.

“she increased the number of sessions per day, resulting in 29 sessions within 12 days.”

Classified as probably not a substantial claim.

To control for unspecific, general improvement, a task unrelated to oral naming and not practiced during intervention was administered before and after treatment.

“To control for unspecific, general improvement, a task unrelated to oral naming and not practiced during intervention was administered before and after treatment.”

• AssumptionRests on an assumption: The control tasks used (writing non-words to dictation for P1, written picture naming for P2, oral non-word repetition for P3) are unrelated to oral naming and not practiced during intervention, so they can control for unspecific general improvement.

May combine two claims.

The study did not compare LingoTalk to other app-based interventions or to traditional face-to-face approaches.

“While our study investigated the effectiveness of an intervention with LingoTalk, it did not compare LingoTalk to other app-based interventions [e.g., neolexon (Jakob and Späth, 2023)] or to traditional face-toface approaches.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The three single cases were combined post-hoc into one case series, resulting in some lack of coherence.

“For the purposes of this paper, we combined these three single cases posthoc into one case series, resulting in some lack of coherence.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Participants used different feedback modes (ASR vs. self-assessment) as one was not able to handle ASR.

“The participants also used different feedback modes (ASR vs. self-assessment) as one of them was not able to handle ASR.”

May combine two claims.

The research originated from three separate Bachelor's theses, each investigating a single case, resulting in slight variations in methodology during neurolinguistic assessment and intervention.

“Our research originated from three separate Bachelor's theses, each investigating a single case, and as such, there were slight variations in methodology during both neurolinguistic assessment and intervention.”

Classified as probably not a substantial claim.

Both feedback modes provide an opportunity for patients to gain independence from their SLT.

“Both feedback modes provide an opportunity for patients to gain independence from their SLT.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Data on within-level generalization for P1 and P2 were not collected.

“Unfortunately, we did not collect such data for P1 and P2.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

Improving lexical retrieval through a self-administered, app-based treatment aligns with a participation-oriented speech-language therapy approach, enhancing everyday communication as advocated by the ICF.

“Improving lexical retrieval through a self-administered, app-based treatment then aligns with a participation-oriented speech-language therapy approach, enhancing everyday communication as advocated by the International Classification of Functioning, Disability, and Health (ICF, World Health Organization, 2001).”

• cites World Health Organization, 2001Not checked yet

  Not checked in the free run.

May combine two claims.

Different tests (AAT and ACL) were used to diagnose aphasia, making patient profiles not entirely comparable.

“For instance, different tests [AAT (Huber et al., 1983) and ACL (Kalbe et al., 2010)] were used to diagnose aphasia, making the patient profiles not entirely comparable.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Generalization to spontaneous speech was based on a rather general, though established, indicator, i.e. the ratio of word-finding difficulties to phrases.

“Generalization to treated items in an untreated task was only addressed for one participant, and generalization to spontaneous speech was based on a rather general, though established, indicator, i.e. the ratio of word-finding difficulties to phrases (Bayer, 1986).”

• cites Bayer, 1986Not checked yet

  Not checked in the free run.

May combine two claims.

LingoTalk's evaluation screen provided patients with transparency regarding their progress, motivating them to persist with the treatment.

“LingoTalk's evaluation screen provided patients with transparency regarding their progress, motivating them to persist with the treatment.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The stable high accuracy in P2 and P3 could indicate a ceiling effect.

“In the cases of two participants, P2 and P3, their accuracy rates exceeded 75% and remained stable after already 15 sessions, which could indicate a ceiling effect.”

May combine two claims.

The efficacy of the intervention was demonstrated for treated items, but evidence for generalization is very limited.

“The efficacy of the intervention was demonstrated for treated items, but evidence for generalization is very limited.”